Prospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Aug 16, 2021; 13(8): 329-335
Published online Aug 16, 2021. doi: 10.4253/wjge.v13.i8.329
Prospective evaluation of the hemorrhoid energy treatment for the management of bleeding internal hemorrhoids
Truptesh H Kothari, Krystle Bittner, Shivangi Kothari, Vivek Kaul
Truptesh H Kothari, Krystle Bittner, Shivangi Kothari, Vivek Kaul, Division of Gastroenterology and Hepatology, University of Rochester Medical Center, Rochester, NY 14642, United States
Author contributions: Kothari TH designed and conceptualized the study; Bittner K collected the data; Kothari TH, Bittner K, Kaul V and Kothari S contributed planning/conducting the study (literature review), interpretation of data, drafting/editing the manuscript, and approved the final draft.
Institutional review board statement: The study was reviewed and approved by the Research Subjects Review Board (University of Rochester Medical Center; approval #780).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors have no conflict of interest to report.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Truptesh H Kothari, FACG, FASGE, MD, MS, Associate Professor, Division of Gastroenterology and Hepatology, University of Rochester Medical Center, 601 Elmwood Ave., Box 646, Rochester, NY 14642, United States. truptesh_kothari@urmc.rochester.edu
Received: December 16, 2020
Peer-review started: December 16, 2020
First decision: March 1, 2021
Revised: April 7, 2021
Accepted: July 19, 2021
Article in press: July 19, 2021
Published online: August 16, 2021
Processing time: 238 Days and 5.9 Hours
Abstract
BACKGROUND

The hemorrhoid energy treatment (HET) system is a non-surgical bipolar electrotherapy device, which has previously demonstrated efficacy in the management of bleeding Grade I and II internal hemorrhoids; however, data is limited.

AIM

To prospectively assess the safety and efficacy of the HET device.

METHODS

This was an IRB-approved prospective study of 73 patients with Grade I or II internal hemorrhoids who underwent HET from March 2016 to June 2019. Patient factors and procedural data were obtained. A post-procedure questionnaire was administered by telephone to all patients at 1-wk and 3-mo following HET to assess for improvement and/or resolution of rectal bleeding and adherence to a stool softener regimen. A chart review was performed to observe recurrent symptoms and durability of response. Statistical analyses were performed using SPSS software (IBM; SPSS Version 25.0).

RESULTS

Seventy-three patients underwent HET during the study period. Mean post-HET follow-up was 1.89 years. Complete resolution of bleeding was reported in 65% at 1 wk (n = 48), with improvement in bleeding in 97.2% (n = 71) of patients. At 3-mo, resolution and/or improvement in bleeding was reported in 90% (n = 64) of patients. No procedure-related pain or adverse events were reported.

CONCLUSION

HET is well tolerated, safe and highly effective in the majority of our patients presenting with Grade I and II symptomatic internal hemorrhoids.

Keywords: Internal hemorrhoids, Bleeding hemorrhoids, Painless bleeding, Mucus, Constipation, Straining

Core Tip: Bleeding internal hemorrhoids are a very common problem. More than 50% of population 50 years or older have issues with constipation leading to painless bleeding. Tremendous amount of money is spent in urgent care and emergency department visits for painless bleeding. Not many treatment modalities are available for internal hemorrhoids. Hemorrhoid energy treatment is a bipolar equipment for treatment of internal hemorrhoids grade I and II. Our study has reflected the benefits of this device through our prospective trial.